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NPI Code Detail

MEDICARE: BANNER HEALTH

MEDICARE: BANNER HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336L0003XLong Term Care Pharmacy
23336C0002XClinic Pharmacy
33336I0012XInstitutional PharmacyY03147AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11987996OTHERPK

General Provider Information

NPI Number : 1598867996
Entity Type Code : Organization
Provider Name (Legal Business Name) : BANNER HEALTH
Provider Business Mailing Address
First Line : 2901 N CENTRAL AVE STE 160
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2702
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1111 E MCDOWELL RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-2612
Country : US
Telephone Number : 602-239-4558
Fax Number : 602-239-6734
Authorized Official
Title or Position : CFO
Name : DENNIS LARAWAY
Credential :
Telephone Number : 602-747-4000
Provider Enumeration Date : 09/05/2006
Last Update Date : 01/31/2022

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Directions to “BANNER HEALTH ” Practice Location

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